Xue Fu Zhu Yu Tang & Varicose Veins
abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)
Keywords: Chinese medicine, Chinese herbal medicine, varicose veins
Varicose veins are enlarged veins that can be flesh colored, dark purple or blue. They often look like
cords and appear twisted and bulging. They are swollen and raised above the surface of the skin. Varicose
veins are commonly found on the backs of the calves or on the inside of the leg. Fifty to 55% of American
women and 40-45% of American men suffer from some form of vein problem. Varicose veins affect one
out of two people age 50 and older. Some common symptoms of varicose veins include aching pain,
easily tired legs, heaviness of the legs, swelling in the legs, darkening of the skin (in severe cases),
numbness in the legs, and itching or an irritated rash in the legs. The squeezing of leg muscles pumps
blood back to the heart from the lower body. Veins have valves that act as one-way flaps. These valves
prevent the blood from flowing backwards as it moves up the legs. If the one-way valves become weak,
blood can leak back into the vein and collect there. This problem is called venous insufficiency. Pooled
blood enlarges the vein and it becomes varicose. The force of gravity, the pressure of body weight, and
the task of carrying blood from the bottom of the body up to the heart make legs the primary location for
varicose and spider veins. Compared with other veins in the body, leg veins have the toughest job of
carrying blood back to the heart. They endure the most pressure. This pressure can be stronger than the
veins' one-way valves.
Many factors increase a person's chances of developing varicose veins. These include:
1. Increasing age
2. Having family members with vein problems or being born with weak vein valves
3. Hormonal changes. These occur during puberty, pregnancy, and menopause. Taking birth control pills
and other medicines containing estrogen and progesterone also increase the risk of varicose or spider
veins
4. Pregnancy. During pregnancy there is a huge increase in the amount of blood in the body. This can
cause veins to enlarge. The expanding uterus also puts pressure on the veins. Varicose veins usually
improve within three months after delivery. A growing number of abnormal veins usually appear with
each additional pregnancy.
5. Obesity, leg injury, prolonged standing and other things that weaken vein valves
On pages 452-453 of issue #6, 2008 of Bei Jing Zhong Yi Yao (Beijing Chinese Medicine &
Pharmacology), Ding Wei-guo et al. published an article titled “Clinical Observations on the Treatment
of Lower Limb Varicose Veins with Xue Fu Zhu Yu Gelatin Capsules.” Xue Fu Zhu Yu Tang (Blood
Mansion Dispel Stasis Decoction) is a famous formula for blood stasis in the thoracic region created by
Wang Qing-ren as found in his Yi Lin Gai Cuo (Correcting the Errors in the Forest of Medicine). An
English translation of this book is available from Blue Poppy Press. A summary of this article is
presented below.
Cohort description:
In this study, there were 18 males and five females aged 35-72 years who had suffered from lower limb
varicose veins from 0.5-10 years.
Treatment method:
All cases in this study were orally administered Xue Fu Zhu Yu Gelatin Capsules at a rate of six capsules
BID after meals. All these cases were treated for two months continuously, and, during this time, all other
Chinese medicinals for quickening the blood and transforming stasis were ceased. These capsules were
produced by the Tianjin Hong Ren Tang Medicinal Manufacturing Company. All these cases were
followed up for two years after treatment.
Study outcomes:
The first table shows the outcomes from this study in terms of improvement in three main clinical
manifestations of varicose veins. The first number in each column shows the total number of cases
followed by the percentage of the total cases in parentheses.
Symptom
Disappeared
Improved
Slight change
No change
Swelling &
heaviness
6 (26.1%)
10 (43.5%)
5 (21.7%)
2 (8.7%)
Visible ropey
veins
4 (17.4%)
8 (34.8%)
8 (34.8%)
3 (13.0%)
Dark
pigmentation
5 (21.7%)
9 (39.1%)
5 (21.7%)
4 (17.4%)
The second table shows changes in mean values in a number of different parameters from before to after
treatment.
Parameter
Before treatment
After treatment
Whole blood low shear
viscosity (mpa ⋅ s)
13.08 ± 3.16
9.01 ± 1.27
Whole blood high shear
viscosity (mpa ⋅ s)
5.14 ± 0.58
2.79 ± 0.89
Whole blood reductive low
shear rate (mpa ⋅ s)
25.88 ± 6.15
19.37 ± 5.87
Whole blood reductive high
shear rate (mpa ⋅ s)
8.36 ± 3.99
4.55 ± 1.19
Hematocrit (%)
46.90 ± 3.17
41.86 ± 2.09
Sedimentation rate (mm/h)
14.79 ± 7.26
9.98 ± 6.57
Fibrinogen (g/L)
3.61 ± 1.14
2.63 ± 1.23
Cholesterol (mmol/L)
5.87 ± 0.96
4.13 ± 0.86
Triglycerides (mmol/L)
2.98 ± 1.75
2.29 ± 0.99
LDL cholesterol (mmol/L)
3.25 ± 1.17
2.18 ± 0.61
HDL cholesterol (mmol/L)
1.87 ± 0.28
1.78 ± 0.39
Thus there were statistically significant (P ⟨ 0.01) changes for the better from before to after treatment in
whole blood low shear viscosity, whole blood reductive low shear viscosity, hematocrit, plasma
fibrinogen, total cholesterol, and LDL cholesterol, while there were even more marked significant (P ⟨
0.05) changes in whole blood high shear viscosity and whole blood reductive high shear viscosity.
On follow-up for two years, two cases had developed ulcers, while three cases had developed eczema.
However, with repeat treatment, all these conditions were cured. No cases relapsed or got worse during
these two years.
Discussion:
According to Drs. Ding et al., in the case of varicose veins, the channels and network vessels are not
flowing smoothly, the movement of qi and blood is difficult, and the qi is stagnant while the blood is
congealed. Therefore, they believe that the treatment principles for this condition should be to quicken the
blood and transform stasis. Xue Fu Zhu Yu Gelatin Capsules quicken the blood and dispel stasis, free the
flow and regulate the qi and blood, transform stasis and stop pain. Within this formula, Dang Gui (Radix
Angelicae Sinensis), Sheng Di (uncooked Radix Rehmanniae), Chuan Xiong (Rhizoma Chuanxiong), and
Chi Shao (Radix Rubra Paeoniae) are the four ingredients in Si Wu Tang (Four Materials Decoction)
which have the effects of cooling the blood, nourishing the blood, and supplementing the blood. Tao Ren
(Semen Persicae) and Hong Hua (Flos Carthami) break the blood and dispel stasis. When added to the
previous four ingredients, these together make Tao Hong Si Wu Tang (Persica & Carthamus Four
Materials Decoction) which moves stasis in the blood aspect. Chai Hu (Radix Bupleuri) and Zhi Qiao
(Fructus Aurantii) course the liver, upbear yang, and move the qi in order to resolve depression in the qi
aspect. Niu Xi (Radix Achyranthis Bidentatae) dispels stasis, frees the flow of the vessels and guides the
other medicinals to move downward. Jie Geng (Radix Platycodi) guides the other medicinals to also
move upward. When these two medicinals are used together, the upbearing and downbearing of the qi and
blood are both taken care of. In addition, by rectifying the qi within the blood, the quickening of the blood
is further enhanced. Research has shown that this formula can improve blood density, viscosity,
aggregation, and agglutination, improve the microcirculation, dilate the blood vessels, and combat
clotting. Hence the authors of this study feel that this formula is definitely effective for the treatment of
lower leg varicosities, especially when treatment is begun early. In that case, the therapeutic effects are
good and the course of treatment can be short.
Personally, I do not agree with Drs. Ding et al. when they say that Dang Gui, Sheng Di, Chuan Xiong,
and Chi Shao cool, nourish, and supplement the blood. While they do do all these things, they are
stronger at cooling and quickening the blood than nourishing and supplementing it. Further, to say that
Tao Ren and Hong Hua break the blood is, I think, an overstatement. Most Chinese say that both these
ingredients have some nourishing and supplementing effect and, therefore, that they transform stasis, not
even dispel stasis. What I am getting at here is that there are three degrees of attacking and draining blood
stasis, going from mildest to most severe. These three degrees are usually ranked as transforming,
dispelling, and breaking. While some may argue that Tao Ren and Hong Hua do dispel stasis, I cannot
think of any Chinese authority, other than the authors of this article, who say that these two medicinals
break the blood. Commonly used medicinals which break the blood are San Leng (Rhizoma Sparganii)
and E Zhu (Rhizoma Zedoariae). These are a whole other level of severity in attacking and draining blood
stasis.
Copyright © Blue Poppy Press, 2008. All rights reserved.